Glycated hemoglobin 9

Many people often have some different changes in their lives, which are very important to the body. There are not only red blood cells and white blood cells, but also glycated hemoglobin in the body. However, this manifestation has different types and different functions, and it also indicates different results during the examination process. So what do the different manifestations represent during this examination process?

Glycated hemoglobin is the product of the combination of hemoglobin in red blood cells in human blood and blood sugar. The combination of blood sugar and hemoglobin to form glycated hemoglobin is an irreversible reaction, which is proportional to the blood sugar concentration and remains for about 120 days. Therefore, glycated hemoglobin can stably and reliably reflect the average blood sugar level within 120 days before the test and is not affected by factors such as the time of blood drawing, whether the patient is fasting, whether insulin is used, etc.

Therefore, the International Diabetes Federation launched a new version of the Asia-Pacific Diabetes Prevention and Control Guidelines, which clearly stipulates that glycated hemoglobin is the internationally recognized "gold standard" for diabetes monitoring. The English code for glycosylated hemoglobin is HbA1c.

However, the results of the glycosylated hemoglobin test should be analyzed specifically based on the blood sugar results. Here are a few examples:

1. Mr. Zhang has had diabetes for 5 years. He takes diabetes very seriously and bought a blood glucose meter to measure his blood sugar regularly. The results of blood glucose monitoring show that his fasting blood glucose is between 6-7mmol/L. Days passed one by one, and a month ago I read in a diabetes publication that "diabetic patients should measure their glycosylated hemoglobin once every three months." Therefore, he came to our department for a blood test last week, and the result showed that his glycated hemoglobin was 8.5%, which is very high. I immediately tested his postprandial blood sugar again, and it was 13.8mmol/L. Therefore, we helped Mr. Zhang analyze that he usually only checked his fasting blood sugar but not after meals, so his blood sugar monitoring was not comprehensive enough. Currently, research evidence shows that when glycated hemoglobin is less than 7.3%, postprandial blood glucose has a greater impact on the level of glycated hemoglobin; when it is between 7.3% and 8.4%, fasting and postprandial blood glucose have similar effects on glycated hemoglobin; when it is greater than 8.5%, fasting blood glucose plays a more important role.

2. Due to the lack of pancreatic islet function, the blood sugar level of patients with type 1 diabetes fluctuates greatly even when using exogenous insulin. They may even suffer from hypoglycemia frequently, followed by hyperglycemia. Since glycated hemoglobin reflects the average value of blood sugar, it is entirely possible for their glycated hemoglobin to be maintained within the normal range. In this case, the value of glycosylated hemoglobin cannot reflect the actual changes in blood sugar.

3. Glycated hemoglobin is also affected by red blood cells. When combined with diseases that affect the quality and quantity of red blood cells (such as kidney disease, hemolytic anemia, etc.), the measured glycated hemoglobin cannot reflect the true blood sugar level.

Therefore, in the clinical treatment of diabetes, if blood sugar and glycosylated hemoglobin can be measured at the same time, the condition can be better judged comprehensively and the treatment plan can be adjusted in time.

When fasting blood glucose exceeds the predicted value corresponding to the patient's glycated hemoglobin, it shows that blood glucose control has not been good in the recent period, which may be related to tension or fatigue during blood collection, excessive eating at dinner, improper treatment, acute complications, etc., and the treatment plan needs to be adjusted.

For example, a diabetic patient's regular monitoring of glycosylated hemoglobin was always between 6% and 7%, and the most recent was 8.2%. This indicates that the previous treatment plan can no longer control blood sugar well and needs to be adjusted. On the contrary, if fasting blood glucose is lower than the predicted value corresponding to glycated hemoglobin, or even reaches the normal standard, it shows that blood glucose is well controlled in the recent period and the treatment is appropriate.

In short, popularizing diabetes knowledge, updating treatment concepts, monitoring and maintaining glycated hemoglobin standards, and using insulin and other drug treatments earlier and more reasonably are particularly important for controlling the occurrence and development of diabetic complications. Currently, clinical practice advocates active treatment methods for patients with type 2 diabetes: early drug treatment and early combined treatment.

If diabetic patients fail to achieve target blood sugar control or if treatment plans are adjusted, their glycosylated hemoglobin should be checked every 3 months; even after blood sugar control reaches the target, their glycosylated hemoglobin should be checked at least twice a year.

The relationship between glycosylated hemoglobin and blood sugar control can be summarized as follows:

4%~6%: Blood sugar is under normal control.

6%~7%: Blood sugar control is relatively ideal.

7%~8%: Blood sugar control is average.

8%~9%: Control is not ideal, and blood sugar control needs to be strengthened, more attention needs to be paid to diet structure and exercise, and the treatment plan needs to be adjusted under the guidance of a doctor.

>9%: Poor blood sugar control is a risk factor for the development of chronic complications. It may cause complications such as diabetic nephropathy, arteriosclerosis, cataracts, and may also lead to acute complications such as ketoacidosis.